This invention relates to medical devices and procedures in general, and more particularly to medical devices and procedures for reconstructing a ligament.
A ligament is a piece of fibrous tissue which connects one bone to another.
Ligaments are frequently damaged (e.g., detached or torn or ruptured, etc.) as the result of injury and/or accident. A damaged ligament can impede proper motion of a joint and cause significant pain.
Various procedures have been developed to repair or replace a damaged ligament. The specific procedures used depend on the particular ligament which is to be restored and on the extent of the damage.
One ligament which is frequently damaged as the result of injury and/or accident is the anterior cruciate ligament (ACL). Looking now at FIG. 1, the ACL 5 extends between the top of the tibia 10 and the bottom of the femur 15. A damaged ACL can cause instability of the knee joint and cause substantial pain and arthritis.
Numerous procedures have been developed to restore the ACL through a graft ligament replacement. In general, and looking now at FIG. 2, these ACL replacement procedures involve drilling a bone tunnel 20 through tibia 10 and up into femur 15. Then a graft ligament 25, consisting of a harvested or artificial ligament or tendon(s), is passed through the tibial portion 30 of tunnel 20 (sometimes referred to as xe2x80x9cthe tibial tunnelxe2x80x9d), across the interior of the joint, and up into the femoral portion 35 of tunnel 20 (sometimes referred to as xe2x80x9cthe femoral tunnelxe2x80x9d). Then a distal portion of graft ligament 25 is secured in femoral tunnel 35, and a proximal portion of graft ligament 25 is secured in tibial tunnel 30.
There are numerous ways in which graft ligament 25 may be positioned in tunnel 20 and secured in position. However, none of the prior art apparatus and methods has proven to be entirely satisfactory, for a variety of reasons.
As a result, one object of the present invention is to provide improved apparatus for reconstructing a ligament.
And another object of the present invention is to provide an improved method for reconstructing a ligament.
These and other objects of the present invention are addressed by a novel apparatus and method for reconstructing a ligament.
In one preferred form of the invention, the invention comprises a method for securing a graft ligament in a bone tunnel, the method comprising the steps of: (1) forming a first bone tunnel in a bone, the first bone tunnel having a first opening at one end thereof, and forming a second bone tunnel in the same bone, the second bone tunnel being transverse to, and intersecting, the first bone tunnel, the second bone tunnel having first and second portions extending from the first bone tunnel, the first portion of the second bone tunnel having a second opening at one end thereof, and the second portion of the second bone tunnel having a third opening at one end thereof; (2) positioning a closed loop of a flexible member within the first bone tunnel and the first portion of the second bone tunnel such that a first portion of the closed loop extends out of the first opening and a second portion of the closed loop extends out of the second opening, parting the closed loop outside the second opening so as to create a first free end and a second free end, and passing the second free end through the second bone tunnel so that the second free end extends out of the third opening, and positioning the graft ligament over a portion of the flexible member extending out of the first opening; and (3) pulling the first and second free ends of the flexible member so as to draw the graft ligament into the first bone tunnel.
In another form of the invention, the invention comprises a system for securing a graft ligament in a bone tunnel, the system comprising a flexible member for positioning the graft ligament in the bone tunnel, the flexible member comprising a closed loop; an inserter for positioning a first portion of the closed loop in the bone tunnel; and a passing pin for withdrawing the first portion of the closed loop from the inserter positioned in the bone tunnel and pulling that portion of the closed loop through a portion of a second bone tunnel which intersects, and extends traverse to, the first-mentioned bone tunnel.
In another form of the invention, the invention. comprises a system for securing a graft ligament in a bone tunnel, the system comprising a flexible member extending through a second bone tunnel which intersects, and extends traverse to, the bone tunnel, the second bone. tunnel having a first opening and a second opening, the flexible member having a first free end extending out of the first opening and a second free end extending out of the second opening, and wherein the graft ligament is Looped. over the flexible member; a cannulated crosspin mounted on the flexible member external to the first opening; a cannulated driver mounted on the flexible member outboard of the cannulated crosspin; and a cannulated bead mounted on the flexible member outboard of the cannulated driver, the cannulated bead having a larger outside diameter than the inside lumen of the cannulated driver; whereby, when tension is applied to the second end of the flexible member, the cannulated driver may be used to pass the cannulated crosspin beneath the graft ligament.